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    917 results match your criteria Erythropoietic Protoporphyria

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    Disturbed iron metabolism in erythropoietic protoporphyria and association of GDF15 and gender with disease severity.
    J Inherit Metab Dis 2017 Feb 9. Epub 2017 Feb 9.
    Porphyria Centre San Gallicano Dermatological Institute IRCCS, Rome, Italy.
    Patients with erythropoietic protoporphyria (EPP) have reduced activity of the enzyme ferrochelatase that catalyzes the insertion of iron into protoporphyrin IX (PPIX) to form heme. As the result of ferrochelatase deficiency, PPIX accumulates and causes severe photosensitivity. Among different patients, the concentration of PPIX varies considerably. Read More

    Acute hepatic and erythropoietic porphyrias: from ALA synthases 1 and 2 to new molecular bases and treatments.
    Curr Opin Hematol 2017 Jan 21. Epub 2017 Jan 21.
    aINSERM U1149 CNRS ERL 8252, Centre de Recherche sur l'inflammation, Université Paris Diderot, site Bichat, Sorbonne Paris Cité bLaboratory of excellence, GR-Ex, Paris cAP-HP, Centre Français des Porphyries, Hôpital Louis Mourier, Colombes dAP-HP, Hôpital Beaujon, Service de Biochimie Clinique, Clichy, France.
    Purpose Of Review: Many studies over the past decade have together identified new genes including modifier genes and new regulation and pathophysiological mechanisms in inherited inborn diseases of the heme biosynthetic pathway. A new porphyria has been characterized: X-linked protoporphyria and the perspective to have innovative treatment at very short-term became a reality. We will summarize how recent data on both ALAS1 and ALAS2 have informed our understanding of disease pathogenesis with an emphasis on how this information may contribute to new therapeutic strategies. Read More

    Modelling the ferrochelatase c.315-48C modifier mutation for erythropoietic protoporphyria (EPP) in mice.
    Dis Model Mech 2017 Jan 12. Epub 2017 Jan 12.
    Institute of Laboratory Medicine, Municipal Hospital Triemli, 8063 Zürich, Switzerland
    Erythropoietic Protoporphyria (EPP) is caused by deficiency of ferrochelatase (FECH) which incorporates iron into protoporphyrin IX (PPIX) to form heme. Excitation of accumulated PPIX by light generates oxygen radicals which evoke excessive pain and, after longer light exposure, ulcerations in exposed skin areas of EPP patients. Moreover, ∼5% of the patients develop a liver dysfunction due to PPIX accumulation. Read More

    Erythropoietic Protoporphyria (EPP), a Clinical and Molecular Study from Lebanon: Ferrochelatase a Potential Tumor Suppressor Gene in Colon Cancer.
    Clin Genet 2017 Jan 11. Epub 2017 Jan 11.
    Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon.
    Erythropoietic protoporphyria (EPP) is a rare cutaneous and systemic disease caused by mutations in the ferrochelatase gene (FECH). The molecular underpinnings of EPP in Middle Eastern populations and relative to other ethnic groups secondary to increased consanguinity are unknown. To understand the molecular pathogenesis of Middle Eastern EPP, we surveyed clinicopathological and molecular features in six large consanguineous families from Lebanon and Syria presenting with cutaneous and systemic features consistent with EPP. Read More

    Pharmacokinetics and Pharmacodynamics of Afamelanotide and its Clinical Use in Treating Dermatologic Disorders.
    Clin Pharmacokinet 2017 Jan 6. Epub 2017 Jan 6.
    Stadtspital Triemli, Institute of Laboratory Medicine, Zurich, Switzerland.
    Afamelanotide, the first α-melanocyte-stimulating hormone (MSH) analogue, synthesized in 1980, was broadly investigated in all aspects of pigmentation because its activity and stability were higher than the natural hormone. Afamelanotide binds to the melanocortin-1 receptor (MC1R), and MC1R signaling increases melanin synthesis, induces antioxidant activities, enhances DNA repair processes and modulates inflammation. The loss-of-function variants of the MC1R present in fair-skinned Caucasians are less effectively activated by the natural hormone. Read More

    Ferrochelatase gene mutation in Singapore and a novel frame-shift mutation in an Asian boy with erythropoietic protoporphyria.
    Int J Dermatol 2017 Mar 4;56(3):272-276. Epub 2017 Jan 4.
    Department of Dermatology, National Skin Center, Singapore.
    Background: Erythropoietic protoporphyria (EPP) is a rare inherited disorder of heme biosynthesis caused by decreased activity of the enzyme ferrochelatase (FECH ). The frequency of the hypomorphic c.333-48C allele in a population directly contributes to the prevalence of EPP in the same population. Read More

    Case of late-onset erythropoietic protoporphyria with myelodysplastic syndrome who has homozygous IVS3-48C polymorphism in the ferrochelatase gene.
    J Dermatol 2016 Dec 27. Epub 2016 Dec 27.
    Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
    We report the case of a 42-year-old man with a 5-year history of myelodysplastic syndrome and photosensitivity who had developed painful erythema and blisters on sun-exposed sites. Histological examination of a mildly lichenified lesion on the dorsal finger revealed extensive deposits of a hyaline-like, periodic acid-Schiff-positive material around superficial dermal blood vessels. Laboratory tests showed elevated erythrocyte protoporphyrin and normal urinary porphyrins, suggesting a diagnosis of erythropoietic protoporphyria. Read More

    Advances in the management of erythropoietic protoporphyria - role of afamelanotide.
    Appl Clin Genet 2016 12;9:179-189. Epub 2016 Dec 12.
    Department of Internal Medicine, Section on Gastroenterology.
    Erythropoietic protoporphyria (EPP) and the phenotypically similar disease X-linked protoporphyria (XLPP) are inherited cutaneous porphyrias characterized clinically by acute non-blistering photosensitivity, intolerance to sunlight, and significantly reduced quality of life. They are due to marked overproduction of protoporphyrin (PP) chiefly by erythroblasts and reticulocytes. In EPP, the underlying genetic defect is in the ferrochelatase gene, which encodes the final enzyme in the heme synthetic pathway. Read More

    Patients with erythropoietic protoporphyria have reduced erythrocyte protoporphyrin IX from early in pregnancy.
    Br J Dermatol 2016 Dec 10. Epub 2016 Dec 10.
    Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
    Erythropoietic protoporphyria (EPP) is a rare genetic disorder characterized by a reduced activity of the enzyme ferrochelatase (FECH), which converts protoporphyrin IX (PpIX) into heme. This results in PpIX accumulation in erythrocytes both in a free form and bound to zinc. In the present paper we only investigate the free form since it can be transferred to plasma and tissue including the skin where it generates painful skin reactions upon exposure to sunlight. Read More

    Stereotactic Body Radiotherapy for Hepatocellular Carcinoma Resulting in a Durable Relapse-Free Survival: A Case Report.
    Cureus 2016 Oct 24;8(10):e841. Epub 2016 Oct 24.
    Radiation Oncology, University of Utah Huntsman Cancer Hospital.
    The standard of care for localized hepatocellular carcinoma (HCC) is surgical resection. For patients who decline or who are unfit for surgery, stereotactic body radiotherapy (SBRT) is emerging as a viable treatment approach. We present a case of a 77-year-old female in whom an early stage HCC was incidentally discovered. Read More

    Case Report of Patient With Erythropoietic Protoporphyria and Basal Cell Carcinoma Diagnoses.
    J Cutan Med Surg 2016 Nov 11. Epub 2016 Nov 11.
    Department of Internal Medicine, College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
    Background: Basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer. There is a clear association between BCC development and ultraviolet (UV) radiation. Erythropoietic protoporphyria (EPP) is an inherited porphyria disorder that is a result of protoporphyrin accumulation, typically manifesting with phototoxicity. Read More

    Protoporphyrin IX in the skin measured noninvasively predicts photosensitivity in patients with erythropoietic protoporphyria.
    Br J Dermatol 2016 Dec 17;175(6):1284-1289. Epub 2016 Oct 17.
    Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
    Background: Erythropoietic protoporphyria (EPP) is a rare genetic disease that causes severe sensitivity to visible light as a result of protoporphyrin IX (PpIX) accumulation in the skin.

    Objectives: To establish a noninvasive method to measure PpIX in the skin of patients with EPP and to investigate how skin PpIX relates to erythrocyte PpIX and photosensitivity.

    Methods: Skin PpIX was measured in 25 patients with EPP by calculating the difference in PpIX fluorescence before and after complete photobleaching of PpIX using controlled illumination. Read More

    Identification of FECH gene multiple variations in two Chinese patients with erythropoietic protoporphyria and a review.
    J Zhejiang Univ Sci B 2016 Oct.;17(10):813-820
    Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
    Erythropoietic protoporphyria (EPP), an autosomal dominant disease, is caused by partial deficiency of ferrochelatase (FECH), which catalyzes the terminal step of heme biosynthesis because of loss-of-function mutations in the FECH gene. To date, only a few cases have been described in Asia. In this study, we describe the clinical features of two Chinese patients with EPP, with diagnosis confirmed by the increase of free protoporphyrin in erythrocytes, detection of plasma fluorescence peak at 630-634 nm, and analysis of FECH gene mutations. Read More

    Novel Treatment Using Cimetidine for Erythropoietic Protoporphyria in Children.
    JAMA Dermatol 2016 Nov;152(11):1258-1261
    Department of Dermatology, Stanford University, Stanford, California.
    Importance: Erythropoietic protoporphyria (EPP) is a rare hereditary disease of heme biosynthesis that manifests as severe photosensitivity and hepatotoxicity. There have been no effective treatments to date. Cimetidine has been shown to inhibit heme biosynthesis and results in symptomatic improvement in patients with acute intermittent porphyria (AIP) and porphyria cutanea tarda (PCT). Read More

    A case of erythropoietic protoporphyria.
    Proc (Bayl Univ Med Cent) 2016 Jul;29(3):311-2
    Department of Pathology, University of South Carolina, Charleston (Lindsey); and the Departments of Hematology/Oncology (Burch) and Pathology (Krause), Baylor University Medical Center at Dallas and Baylor Sammons Cancer Center, Dallas, Texas.
    A 53-year-old Texas rancher developed a blistering skin rash that was sensitive to exposure to sunlight. He was referred to hematology with a presumptive diagnosis of porphyria. His peripheral blood counts were within normal limits, and a bone marrow examination revealed erythroid dyspoiesis and ringed sideroblasts. Read More

    Exome Genotyping Identifies Pleiotropic Variants Associated with Red Blood Cell Traits.
    Am J Hum Genet 2016 Jul 23;99(1):8-21. Epub 2016 Jun 23.
    Department of Medicine, Université de Montréal, Montréal, QC H3T 1J4, Canada; Montreal Heart Institute, Montréal, QC H1T 1C8, Canada. Electronic address:
    Red blood cell (RBC) traits are important heritable clinical biomarkers and modifiers of disease severity. To identify coding genetic variants associated with these traits, we conducted meta-analyses of seven RBC phenotypes in 130,273 multi-ethnic individuals from studies genotyped on an exome array. After conditional analyses and replication in 27,480 independent individuals, we identified 16 new RBC variants. Read More

    Cutaneous Porphyrias: Causes, Symptoms, Treatments and the Danish Incidence 1989-2013.
    Acta Derm Venereol 2016 Nov;96(7):868-872
    Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, 5000 Odense C, Denmark.
    Porphyrias are rare diseases caused by altered haem synthesis leading to the accumulation of different haem intermediates. Neurovisceral attacks may occur in acute porphyrias, while photosensitivity is the presenting symptom in cutaneous porphyrias. We present here an overview of symptoms and a flowchart for the diagnosis of cutaneous porphyrias, with recommendations for monitoring and an update of treatment options. Read More

    [Cutaneous changes in long-standing erythropoietic protoporphyria].
    Hautarzt 2016 Jun;67(6):479-82
    Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
    Erythropoietic protoporphyria results in highly increased photosensitivity of the skin. Solar irradiation causes sunburn-like symptoms with erythema, edema and wheals. We report the case of a 60-year-old man suffering from erythropoietic protoporphyria since his childhood who additionally developed chronic cutaneous lichenoid papules in sun-exposed skin areas. Read More

    Influence of meteorological data on sun tolerance in patients with erythropoietic protoporphyria in France.
    Br J Dermatol 2016 Oct 13;175(4):768-75. Epub 2016 Jul 13.
    Department of Dermatology, Centre Hospitalier Universitaire (CHU) Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093, Nantes Cedex 1, France.
    Background: Erythropoietic protoporphyria (EPP) is a rare metabolic disorder, characterized by photosensitivity, caused by errors of the haem biosynthetic pathway. Avoidance of sun exposure is recommended; however, some patients suggested a paradoxical improvement of symptoms when they move to sunny areas.

    Objectives: In a national French study, we sought to investigate the influence of sun exposure on EPP symptoms. Read More

    Afamelanotide: A Review in Erythropoietic Protoporphyria.
    Am J Clin Dermatol 2016 Apr;17(2):179-85
    Springer, Private Bag 65901, Mairangi Bay 0754, Auckland, New Zealand.
    Afamelanotide (SCENESSE(®)) is a synthetic α-melanocyte stimulating hormone analogue and first-in-class melanocortin-1 receptor agonist that is approved in the EU for the prevention of phototoxicity in adults with erythropoietic protoporphyria (EPP). It is administered subcutaneously as a biodegradable, controlled-release implant containing 16 mg of afamelanotide. This article reviews the clinical efficacy and tolerability of afamelanotide in EPP and summarizes its pharmacological properties. Read More

    A Novel Mutation in the FECH Gene in a Czech Family with Erythropoietic Protoporphyria and a Population Study of IVS3-48C Variant Contributing to the Disease.
    Folia Biol (Praha) 2015 ;61(6):227-32
    Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic.
    Erythropoietic protoporphyria (EPP), a chronic erythropoietic porphyria, is characterized by excess accumulation of protoporphyrin, particularly in erythroid cells. EPP inheritance is complex, almost always associated with two molecular defects. In most EPP patients, clinical expression requires coinheritance of a private ferrochelatase (FECH) mutation trans- to a hypomorphic FECH*IVS3-48C allele. Read More

    [Erythropoietic protoporphyria : Clinical manifestations, diagnosis and new therapeutic possibilities].
    Hautarzt 2016 Mar;67(3):211-5
    Hautklinik und Europäisches Porphyriezentrum, Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Moorenstr. 5, Deutschland.
    Background: Erythropoietic protoporphyria, the second most common type of the cutaneous porphyrias, is due to an enzymatic deficiency of ferrochelatase, the last enzyme in heme biosynthesis. The enzyme defect leads to an accumulation of protoporphyrin IX in erythrocytes and an elevated excretion of this metabolite in the feces.

    Clinical Presentation: Usually, disease onset is in early infancy, characterized by increased photosensitivity. Read More

    Solar urticaria.
    J Dtsch Dermatol Ges 2015 Dec;13(12):1250-3
    Department of Dermatology, University Medical Center Jena, Jena, Germany.
    Solar urticaria is a rare IgE-mediated and chromophore-dependent photodermatosis. In some cases, these chromophores, designated as "serum factor", may be detected in serum or plasma. To date, the exact pathogenesis of solar urticaria has, however, not been elucidated. Read More

    Pitfalls in Erythrocyte Protoporphyrin Measurement for Diagnosis and Monitoring of Protoporphyrias.
    Clin Chem 2015 Dec 19;61(12):1453-6. Epub 2015 Oct 19.
    University of Texas Medical Branch, Galveston, TX;
    Background: Laboratory diagnosis of erythropoietic protoporphyria (EPP) requires a marked increase in total erythrocyte protoporphyrin (300-5000 μg/dL erythrocytes, reference interval <80 μg/dL) and a predominance (85%-100%) of metal-free protoporphyrin [normal, mostly zinc protoporphyrin (reference intervals for the zinc protoporphyrin proportion have not been established)]; plasma porphyrins are not always increased. X-linked protoporphyria (XLP) causes a similar increase in total erythrocyte protoporphyrin with a lower fraction of metal-free protoporphyrin (50%-85% of the total).

    Content: In studying more than 180 patients with EPP and XLP, the Porphyrias Consortium found that erythrocyte protoporphyrin concentrations for some patients were much higher (4. Read More

    X-linked dominant protoporphyria: The first reported Japanese case.
    J Dermatol 2016 Apr 21;43(4):414-8. Epub 2015 Sep 21.
    Department of Dermatology, Osaka Medical College, Osaka, Japan.
    A 12-year-old boy with photosensitivity since 3 years of age presented with small concavities on both cheeks, the nasal root and the dorsal surface of both hands. According to the clinical features, erythropoietic protoporphyria (EPP) was suspected. Urine and blood samples were tested for porphyrin derivatives, which revealed a markedly elevated level of erythrocyte protoporphyrin (EP) and a diagnosis of EPP was made. Read More

    A metabolomic perspective of griseofulvin-induced liver injury in mice.
    Biochem Pharmacol 2015 Dec 5;98(3):493-501. Epub 2015 Sep 5.
    Center for Pharmacogenetics, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. Electronic address:
    Griseofulvin (GSF) causes hepatic porphyria in mice, which mimics the liver injury associated with erythropoietic protoporphyria (EPP) in humans. The current study investigated the biochemical basis of GSF-induced liver injury in mice using a metabolimic approach. GSF treatment in mice resulted in significant accumulations of protoporphyrin IX (PPIX), N-methyl PPIX, bile acids, and glutathione (GSH) in the liver. Read More

    Human Erythroid 5-Aminolevulinate Synthase Mutations Associated with X-Linked Protoporphyria Disrupt the Conformational Equilibrium and Enhance Product Release.
    Biochemistry 2015 Sep 2;54(36):5617-31. Epub 2015 Sep 2.
    Department of Molecular Medicine, Morsani College of Medicine, University of South Florida , Tampa, Florida 33612, United States.
    Regulation of 5-aminolevulinate synthase (ALAS) is at the origin of balanced heme production in mammals. Mutations in the C-terminal region of human erythroid-specific ALAS (hALAS2) are associated with X-linked protoporphyria (XLPP), a disease characterized by extreme photosensitivity, with elevated blood concentrations of free protoporphyrin IX and zinc protoporphyrin. To investigate the molecular basis for this disease, recombinant hALAS2 and variants of the enzyme harboring the gain-of-function XLPP mutations were constructed, purified, and analyzed kinetically, spectroscopically, and thermodynamically. Read More

    Incomplete erythropoietic protoporphyria caused by a splice site modulator homozygous IVS3-48C polymorphism in the ferrochelatase gene.
    Br J Dermatol 2016 Jan 7;174(1):172-5. Epub 2015 Nov 7.
    Department of Dermatology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Sugitani, Toyama, 930-0194, Japan.
    Erythropoietic protoporphyria (EPP) is an inherited cutaneous porphyria caused by both the partial deficiency of ferrochelatase (FECH) and the existence of cytosine at IVS3-48 in trans to a mutated FECH allele. However, physicians occasionally encounter patients with EPP with a mild phenotype associated with a slight increase in the erythrocyte-free protoporphyrin concentration and no FECH gene mutations. In this study, genetic analyses were performed on three patients with a mild phenotype of EPP, with photosensitivity, slightly increased erythrocyte-free protoporphyrin concentrations and only a few fluorocytes in the peripheral blood. Read More

    [A patient diagnosed herself with erythropoietic protoporphyria after googling photosensitivity].
    Ugeskr Laeger 2015 Jul;177(30)
    Afdeling for Klinisk Biokemi og Farmakologi, Odense Universitetshospital, Sdr. Boulevard 29, 5000 Odense C.
    Erythropoietic protoporphyria (EPP) is rare genetic disease caused by decreased activity of the eighth enzyme in the haem synthesis. Patients are photosensitive, getting stinging and burning sensations in the skin after sun exposure. Delayed diagnosis of these patients is not seldom because of the rarity in combination with not always visible skin symptoms. Read More

    Ambient Light Promotes Selective Subcellular Proteotoxicity after Endogenous and Exogenous Porphyrinogenic Stress.
    J Biol Chem 2015 Sep 23;290(39):23711-24. Epub 2015 Jul 23.
    From the Departments of Molecular and Integrative Physiology, Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan 48109 and the Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan 48105.
    Hepatic accumulation of protoporphyrin-IX (PP-IX) in erythropoietic protoporphyria (EPP) or X-linked-dominant protoporphyria (XLP) cause liver damage. Hepatocyte nuclear lamin aggregation is a sensitive marker for PP-IX-mediated liver injury. We tested the hypothesis that extracellular or intracellular protoporphyria cause damage to different subcellular compartments, in a light-triggered manner. Read More

    Homeostasis of iron and hepcidin in erythropoietic protoporphyria.
    Eur J Clin Invest 2015 Oct 2;45(10):1032-41. Epub 2015 Sep 2.
    The Liver-Biliary-Pancreatic Center, Carolinas HealthCare System, Charlotte, NC, USA.
    Background: Erythropoietic protoporphyria (EPP) and X-linked protoporphyria (XLP) are genetic abnormalities of heme synthesis that result in excess production of protoporphyrin and that manifest as severe photosensitivity. These disorders are often associated with iron deficiency anaemia (IDA). Our aim was to determine whether hepcidin is increased in EPP/XLP patients, resulting in decreased enteral iron absorption and IDA. Read More

    A second attack of cholestasis associated with erythropoietic protoporphyria was successfully treated by plasma exchange and blood transfusion.
    Clin J Gastroenterol 2014 Aug 10;7(4):333-7. Epub 2014 Jun 10.
    Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan,
    Erythropoietic protoporphyria (EPP) is a rare hereditary disease that can sometimes cause acute liver failure based on cholestasis. Acute liver failure is a fatal complication and is associated with EPP in 1-4 % of patients. Although it is extremely difficult to recover from acute liver failure, we experienced an important case of EPP where the patient recovered from the first attack of cholestasis with antibiotic treatment. Read More

    Porphyrias: A 2015 update.
    Clin Res Hepatol Gastroenterol 2015 Sep 2;39(4):412-25. Epub 2015 Jul 2.
    INSERM U1149 CNRS ERL 8252, centre de recherche sur l'inflammation, 16, rue Henri-Huchard, 75018 Paris, France; Université Versailles-Saint-Quentin, 55, Avenue de Paris, 78000 Versailles, France; Université Paris Diderot, site Bichat, Sorbonne Paris Cité, 75018 Paris, France; Centre français des porphyries, hôpital Louis-Mourier, AP-HP, 92701 Colombes, France. Electronic address:
    The hereditary porphyrias comprise a group of eight metabolic disorders of the heme biosynthesis pathway. Each porphyria is caused by abnormal function at a separate enzymatic step resulting in a specific accumulation of heme precursors. Porphyrias are classified as hepatic or erythropoietic, based on the organ system in which heme precursors (δ-aminolevulinic acid [ALA], porphobilinogen and porphyrins) are overproduced. Read More

    Bovine congenital erythropoietic protoporphyria in a crossbred limousin heifer in Ireland.
    Ir Vet J 2015 2;68(1):15. Epub 2015 Jul 2.
    School of Veterinary Medicine, University College Dublin, Dublin, Ireland.
    An unusual case of an 11-month-old, black Limousin-cross heifer, with an 8-month history of episodic seizures and photosensitisation, was referred by a veterinary practitioner to the Farm Animal Section of the UCD Veterinary Hospital, School of Veterinary Medicine, University College Dublin, Ireland, in August 2014. Following an investigation, a diagnosis of Bovine Congenital Erythropoietic Protoporphyria (BCEPP) was made. To the authors' knowledge this is the first report of such a case in Ireland. Read More

    Afamelanotide for Erythropoietic Protoporphyria.
    N Engl J Med 2015 Jul;373(1):48-59
    From the Department of Internal Medicine, Center of Lysosomal and Metabolic Diseases, Erasmus Medical Center, Rotterdam (J.G.L., F.P.J.K., E.J.G.S., F.W.M.R., J.H.P.W.), and the Department of Dermatology, Maastricht University Medical Center, Maastricht (J.F.) - both in the Netherlands; the Departments of Genetics and Genomic Sciences (M.B., H.N., R.J.D.) and Dermatology (M.L.), Icahn School of Medicine at Mount Sinai, New York; the Departments of Preventive Medicine and Community Health, and Internal Medicine and the Institute for Translational Sciences, University of Texas Medical Branch, Galveston (K.E.A.); the Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC (H.L.B.); Royal Gwent Hospital, Newport (A.V.A., C.E.), the Centre for Dermatology, University of Manchester, Salford Royal Hospital, Manchester (L.E.R.), and the Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford (C.R.G.) - all in the United Kingdom; the Department of Medicine, University of California, San Francisco, San Francisco (D.M.B.); the Department of Medicine, University of Alabama, Birmingham (J.B.); the Department of Dermatology, Heinrich Heine University, Duesseldorf, Germany (N.J.N., J.F.); the Department of Internal Medicine, University of Utah, Salt Lake City (C.P., J.D.P.); the Department of Dermatology, Henry Ford Hospital, Detroit (H.W.L., I.H.); Hôpital Louis-Mourier, Hôpitaux Universitaire Paris Nord Val de Seine, Assistance Publique-Hôpitaux de Paris, INSERM Unité 1149, Université Paris Diderot, Colombes, France (J.-C.D.); the Departments of Medicine and Dermatology, University Hospital of Helsinki, Helsinki (R.K.); and the Department of Dermatology, Beaumont Hospital, Dublin (G.M.M.).
    Background: Erythropoietic protoporphyria is a severe photodermatosis that is associated with acute phototoxicity. Patients with this condition have excruciating pain and a markedly reduced quality of life. We evaluated the safety and efficacy of an α-melanocyte-stimulating hormone analogue, afamelanotide, to decrease pain and improve quality of life. Read More

    Porphyria Diagnostics-Part 1: A Brief Overview of the Porphyrias.
    Curr Protoc Hum Genet 2015 Jul 1;86:17.20.1-26. Epub 2015 Jul 1.
    Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, Texas.
    Porphyria diseases are a group of metabolic disorders caused by abnormal functioning of heme biosynthesis enzymes and characterized by excessive accumulation and excretion of porphyrins and their precursors. Precisely which of these chemicals builds up depends on the type of porphyria. Porphyria is not a single disease but a group of nine disorders: acute intermittent porphyria (AIP), hereditary coproporphyria (HCP), variegate porphyria (VP), δ-aminolevulinic acid dehydratase deficiency porphyria (ADP), porphyria cutanea tarda (PCT), hepatoerythropoietic porphyria (HEP), congenital erythropoietic porphyria (CEP), erythropoietic protoporphyria (EPP), and X-linked protoporphyria (XLP). Read More

    Total hip arthroplasty in very young bone marrow transplant patients.
    J Surg Orthop Adv 2015 ;24(2):99-104
    Duke University Medical Center, Department of Orthopaedic Surgery, Durham, North Carolina.
    Concerns remain about total hip arthroplasty (THA) performed in very young patients, especially those with complex medical history such as allogeneic bone marrow transplantation (ABMT). This study retrospectively reviews the perioperative courses and functional outcomes of ABMT patients <21 years old undergoing primary uncemented THA. Nine THAs were performed in five ABMT patients at an average age of 19. Read More

    Experimental protoporphyria: effect of bile acids on liver damage induced by griseofulvin.
    Biomed Res Int 2015 7;2015:436319. Epub 2015 Apr 7.
    Centro de Investigaciones sobre Porfirinas y Porfirias, CONICET-UBA, Avenida Córdoba 2351, 1120 Buenos Aires, Argentina.
    The effect of bile acids administration to an experimental mice model of Protoporphyria produced by griseofulvin (Gris) was investigated. The aim was to assess whether porphyrin excretion could be accelerated by bile acids treatment in an attempt to diminish liver damage induced by Gris. Liver damage markers, heme metabolism, and oxidative stress parameters were analyzed in mice treated with Gris and deoxycholic (DXA), dehydrocholic (DHA), chenodeoxycholic, or ursodeoxycholic (URSO). Read More

    Bone marrow transplant for X-linked protoporphyria with severe hepatic fibrosis.
    Pediatr Transplant 2015 Jun 9;19(4):E106-10. Epub 2015 Apr 9.
    Department of Pediatrics, Childrens Mercy Hospital, Kansas City, MO, USA.
    XLP is an erythroid porphyria that results in variable cutaneous photosensitivity due to accumulation of protoporphyrin. The genetic defect in XLP is mutation of the gene ALAS2, resulting in gain of function for the erythroid enzyme 5-aminolevulinate synthase 2. Previous reports have shown that protoporphyrin-induced liver disease may also occur in XLP, occasionally severe enough to warrant liver transplantation; however, transplantation may be followed by injury to the graft due to continued presence of the underlying metabolic disorder in the bone marrow. Read More

    Iron misregulation and neurodegenerative disease in mouse models that lack iron regulatory proteins.
    Neurobiol Dis 2015 Sep 11;81:66-75. Epub 2015 Mar 11.
    Section on Human Iron Metabolism, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA. Electronic address:
    Iron regulatory proteins 1 and 2 (IRP1 and IRP2) are two cytosolic proteins that maintain cellular iron homeostasis by binding to RNA stem loops known as iron responsive elements (IREs) that are found in the untranslated regions of target mRNAs that encode proteins involved in iron metabolism. IRPs modify the expression of iron metabolism genes, and global and tissue-specific knockout mice have been made to evaluate the physiological significance of these iron regulatory proteins (Irps). Here, we will discuss the results of the studies that have been performed with mice engineered to lack the expression of one or both Irps and made in different strains using different methodologies. Read More

    [Update on the biology of heme synthesis in erythroid cells].
    Rinsho Ketsueki 2015 Feb;56(2):119-27
    Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine.
    Heme is a prosthetic group of hemoproteins playing important roles in oxygen transport, detoxification, circadian rhythm, microRNA processing, regulation of transcription, and translation. The majority of heme (-85%) is synthesized in red blood cells mainly for hemoglobin production, whereas hepatocytes account for most of the rest, functioning primarily in the synthesis of cytochrome P450 enzymes and mitochondrial respiratory enzymes. Thus, failure of heme biosynthesis causes severe inherited or acquired disorders in humans, including porphyria and sideroblastic anemia. Read More

    X-chromosomal inactivation directly influences the phenotypic manifestation of X-linked protoporphyria.
    Clin Genet 2016 Jan 17;89(1):20-6. Epub 2015 Feb 17.
    Fondazione IRCCS "Cà-Granda" Ospedale Maggiore Policlinico, U.O. di Medicina Interna, Milano, Italy.
    X-linked protoporphyria (XLP), a rare erythropoietic porphyria, results from terminal exon gain-of-function mutations in the ALAS2 gene causing increased ALAS2 activity and markedly increased erythrocyte protoporphyrin levels. Patients present with severe cutaneous photosensitivity and may develop liver dysfunction. XLP was originally reported as X-linked dominant with 100% penetrance in males and females. Read More

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